Seven cases of surgical native valve endocarditis caused by coagulase-negative staphylococci: An underappreciated disease

Miele, Peter; Kogulan, Palaniandy; Levy, Charles S.; Goldstein, Steven; Marcus, Kendall A.; Smith, Margo A.; Rosenthal, Jonathan; Croxton, Michele; Gill, Vee J.; Lucey, Daniel R.

doi:10.1067/mhj.2001.118119

Cited by 34 publications

(22 citation statements)

References 17 publications

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“…CoNS bacteremia has traditionally been associated with low virulence, and the need for treatment has even been questioned by clinical guidelines [4]. However, frank sepsis syndrome and fatal outcome may occur, especially in immunocompromised patients and/or if one of the more virulent species, such as S. lugdunensis, is involved [19][20][21]. Although no cases of S. lugdunensis bacteremia was included in the current study, the study population included severely ill patients, as reflected by the fact that the median Charlson comorbidity index was 7 (IQR 5-9).…”

Section: Discussionmentioning

confidence: 99%

Coagulase-negative staphylococcal bacteremia: risk factors for mortality and impact of initial appropriate antimicrobial therapy on outcome

Park

Kwon

Chung

et al. 2015

Eur J Clin Microbiol Infect Dis

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It is uncertain whether an initial inappropriate empirical antibiotic treatment of coagulase-negative staphylococci (CoNS) bacteremia adversely affects the outcome. A retrospective cohort study of CoNS bacteremia was performed at the Dongguk University Ilsan Hospital during a 3-year period. During the study period, 109 patients with CoNS bacteremia were enrolled. The median age of the patients was 72 years and most (96%, 105/109) had one or more comorbid diseases. Among the participants, 29% (32/109) received an appropriate empirical antimicrobial therapy. The 30-day mortality was 24% (26/109) and CoNS bacteremia-related mortality was 14% (15/109). There was no difference in the CoNS bacteremia-related mortality between the group with an inappropriate empirical treatment (13%, 10/77) and that with an appropriate treatment (16%, 5/32) (p = 0.46). In the multivariate analysis using the Cox regression analysis method, Pitt bacteremia scores [hazard ratio (HR) 1.48; 95% confidence interval (CI) 1.09-2.01; p = 0.01] and retention of eradicable focus (HR 5.0; 95% CI 1.39-17.9; p = 0.01) were found to be associated with CoNS bacteremia-related mortality. The results suggest that inappropriate empirical therapy might not necessarily be associated with the 30-day mortality or CoNS bacteremia-related mortality. Conversely, Pitt bacteremia scores and retention of eradicable focus were associated with poor outcomes.

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Section: Discussionmentioning

confidence: 99%

Coagulase-negative staphylococcal bacteremia: risk factors for mortality and impact of initial appropriate antimicrobial therapy on outcome

Park

Kwon

Chung

et al. 2015

Eur J Clin Microbiol Infect Dis

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“…Similar to our case, eradication was found to be difficult and required a combination of surgery and antibiotics. However, in contrast to our experience, antibiotic resistance did not emerge in that case series [4]. Recently, a report on 99 patients with native valve endocarditis due to CoNS was published [5].…”

Section: Discussionmentioning

confidence: 78%

“…Despite adequate antibiotic therapy, resistance in CoNS may emerge and lead to treatment failure. Recently, seven cases of native valve endocarditis due to S. epidermidis were reported of which three showed an acute course [4]. All seven patients needed cardiac surgery with valve replacement.…”

Section: Discussionmentioning

confidence: 99%

Rapidly Destructive Staphylococcus epidermidis Endocarditis

et al. 2005

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A 29-year-old man with rapidly destructive Staphylococcus epidermidis endocarditis after mitral valve reconstruction is presented. Resistance to rifampin and teicoplanin occurred during antibiotic treatment resulting in clinical failure and valve destruction. Subsequently, the patient was successfully treated, by combining valve replacement with antibiotic therapy including quinupristin/dalfopristin, levofloxacin, and vancomycin. In conclusion, S. epidermidis can cause rapid valve destruction with large vegetations, and combination of surgery and antibiotic therapy may be necessary.

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“…The role of CoNS as pathogens is clinically relevant in the setting of patients with prosthetic materials, that is, artificial joints, neurosurgical shunts, central vascular catheters, and prosthetic heart valves. 1,8 The infecting strains of CoNS NVE are usually methicillin-sensitive and have no obvious source. This contrasts with CoNS PVE, which is nosocomial in origin and the result of intravascular catheters or other devices, with most strains being methicillinresistant Staphylococci and rapidly destructive.…”

Section: Discussionmentioning

confidence: 99%

“…CoNS are a rare cause of native valve endocarditis (NVE), accounting for less than 5% of cases. 1 CoNS have the ability to colonize the polymer surface of prosthetic materials by the formation of a thick, multilayered biofilm. The CoNS in the biofilm have a slower growth rate as opposed to CoNS not found in biofilm.…”

mentioning

confidence: 99%

Staphylococcus hominis native mitral valve bacterial endocarditis (SBE) in a patient with hypertrophic obstructive cardiomyopathy

2007

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Seven cases of surgical native valve endocarditis caused by coagulase-negative staphylococci: An underappreciated disease

Cited by 34 publications

References 17 publications

Coagulase-negative staphylococcal bacteremia: risk factors for mortality and impact of initial appropriate antimicrobial therapy on outcome

Coagulase-negative staphylococcal bacteremia: risk factors for mortality and impact of initial appropriate antimicrobial therapy on outcome

Rapidly Destructive Staphylococcus epidermidis Endocarditis

Staphylococcus hominis native mitral valve bacterial endocarditis (SBE) in a patient with hypertrophic obstructive cardiomyopathy

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